Thursday, July 31, 2014

Your Parent Has Dementia? Skip the Words; Make Some Music.

Your parent has dementia.  And he or she seems unreachable.  But wait.  The key that unlocks his or her memories and emotions may be as simple as singing a song.

"People with Alzheimer's Disease and other dementias can respond to music when nothing else reaches them," says Oliver Sacks, neurologist, author and contributor to The Oprah Magazine.  "...Musical memory somehow survives the ravages of the disease, and even in people with advanced dementia, music can often reawaken personal memories and associations otherwise lost."

In my own experience working with families and their loved ones with dementia, I've seen the power of music.  The elderly worshipers in a nursing home Sunday service nod off for most of the hour. That is, until, "Amazing Grace," is played.  And miraculously, those who normally have no words can suddenly sing the hymn's lyrics, flawlessly!  In my husband's Grandma's case, Alzheimer's took away her speech, but couldn't snatch the words of "Jesus Loves Me" from her lips.  In her difficult last days, she sang the song.  Those words comforted her, and us, as well.

The Alzheimers Foundation of America offers some suggestions on choosing music to enjoy with your loved one.

1.  Top 10 Picks:  Selections from your parent's young adult years, from ages 18 to 15, offer the most potential for engagement.  Frank Sinatra, Kate Smith, Lawrence Welk, Big Band Music can set your parent's toes tapping.  I remembered one man named Jack whose struggles with memory were forgotten when he attended a weekly dance at the senior center.  Suddenly he was 18 again and the memories flowed. "My buddies and I would drive 100 miles to those dances.  It was wonderful," he said.

2.  Unfamiliar Music:  Because it carries no emotions or memories, this type of music can aid physical relaxation or enhance sleep.  Think soft and soothing.

3.  Late Stage Dementia:  Songs from a person's childhood can comfort, relax, and demonstrate love and caring.  Folk songs in the language the elderly learned them are also powerful.  For those with religious faith, hymns can help them connect with God and with the people they love.

So sing a song.  Even if it's off key.  In the process, you may reach your aging parent in a more powerful way than words alone could do. 

Thursday, July 17, 2014

Medicaid 'Surprises' You May Encounter

Your parent has been approved for Medicaid.  Now what?  He or she will receive care in the home, assisted living, adult family home or nursing home.  Chances are, though, you'll encounter some surprises.  Here are a few:

1.  Your parent could get a roommate.  In most states, the Medicaid program is obligated to provide a shared room if available.  That isn't always possible, though.   In Washington State, many adult family rooms have only private rooms, so when a resident converts to Medicaid funding, he or she gets to stay put.  If your parent happens to be assigned to a shared room and a private room is available, it's sometimes possible for you (the family) to pay the difference between the shared rate and the private rate.

2.  Medicaid covers the basics.  The emphasis is on the basics.  The good news: Medicaid will cover physician services, prescription drug and home health services and also Medicare copays.  Supplies like incontinence products and toilet paper are covered.  Other things aren't paid for in most states such as dental care and transportation to medical appointments, except in limited instances. Many adult family homes, assisted living and nursing homes do have "in-home" physicians who come in on a routine basis to see the residents. Some facilities also have podiatrists coming in, and mobile laboratories for blood draws.

3.  Mom gets an allowance.  Remember when you received one as a child?  Your parent on Medicaid will get a similar monthly personal needs allowance. In Washington State, it's $62.70 for an assisted living or adult family home resident, and $57.28 for a nursing home resident.  Not very much and certainly not enough to cover going out to lunch, buying new clothes or springing for birthday gifts for the grandchildren.  That's where you come in.  You can pay for outings and buy gift cards, clothing or other items.  But you can't legally give your parent large sums of cash, as to put them over the asset limit for Medicaid.  That's $2000 in many states, including Washington.

Note:  Medicaid coverage varies from state to state.  Check out your state's website by googling Medicaid (your state).  Washington State's Medicaid website is found at

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